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1. Previous fracture and subsequent fracture risk: a meta-analysis to update FRAX

Author

Kanis, J.A., Johansson, H., McCloskey, E.V., Liu, E., Åkesson, K.E., Anderson, F.A., Azagra, R., Bager, C.L., Beaudart, C., Bischoff-Ferrari, H.A., Biver, E., Bruyère, O., Cauley, J.A., Center, J.R., Chapurlat, R., Christiansen, C., Cooper, C., Crandall, C.J., Cummings, S.R., da Silva, J.A.P., Dawson-Hughes, B., Diez-Perez, A., Dufour, A.B., Eisman, J.A., Elders, P.J.M., Ferrari, S., Fujita, Y., Fujiwara, S., Glüer, C.-C., Goldshtein, I., Goltzman, D., Gudnason, V., Hall, J., Hans, D., Hoff, M., Hollick, R.J., Huisman, M., Iki, M., Ish-Shalom, S., Jones, G., Karlsson, M.K., Khosla, S., Kiel, D.P., Koh, W.-P., Koromani, F., Kotowicz, M.A., Kröger, H., Kwok, T., Lamy, O., Langhammer, A., Larijani, B., Lippuner, K., Mellström, D., Merlijn, T., Nordström, A., Nordström, P., O’Neill, T.W., Obermayer-Pietsch, B., Ohlsson, C., Orwoll, E.S., Pasco, J.A., Rivadeneira, F., Schott, A.-M., Shiroma, E.J., Siggeirsdottir, K., Simonsick, E.M., Sornay-Rendu, E., Sund, R., Swart, K.M.A., Szulc, P., Tamaki, J., Torgerson, D.J., van Schoor, N.M., van Staa, T.P., Vila, J., Wareham, N.J., Wright, N.C., Yoshimura, N., Zillikens, M.C., Zwart, M., Vandenput, L., Harvey, N.C., Lorentzon, M., and Leslie, W.D.

Published
2023
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7. Update of the fracture risk prediction tool FRAX: A systematic review of potential cohorts and analysis plan

Author

Vandenput, Lisbeth, Johansson, H., McCloskey, E. V., Liu, E., Akesson, Kristina E., Anderson, F.A., Azagra, R., Bager, C.L., Beaudart, Charlotte, Bischoff-Ferrari, H.A., Biver, E., Bruyère, Olivier, Cauley, J.A., Center, J.R., Chapulat, R., Christiansen, C., Cooper, Cyrus, Crandall, Carolyn J., Cummings, Steven, da Silva, J.A.P., Dawson-Hughes, Bess, Diez-Pérez, A., Dufour, Alyssa B., Eisman, J.A., Elders, Petra J.M., Ferrari, S., Fujita, Y., Fujiwara, S., Glüer, C.C., Goldstein, I., Goltzman, D., Gudnason, V., Hall, J., Hans, D., Hoff, M., Hollick, Rosemary J., Huisman, Martijn, Iki, M., Ish-Shalom, S., Jones, G., Karlsson, M.K., Khosla, Sundeep, Kiel, D.P., Koh, W-P, Koromani, F., Kotowicz, M.A., Kroger, H., Kwok, T., Lamy, Olivier, Langhammer, Arnulf, Larijani, Bagher, Lippuner, Kurt, Mellström, D, Merlijn, Thomas, Nordstrom, A., Nordstrom, P., O'Neill, T.W., Obermayer-Piestch, B., Harvey, Nicholas, Kanis, J A., Ohlsson, C., Orwoll, E.S., Pasco, J.A., Rivadeneira, F., Schei, B., Schott, A.M., Shiroma, E.J., Siggeirsdottir, K., Simonsick, E.M., Sornay-Rendu, E., Sund, R., Swart, K.M.A., Szulc, P., Tamaki, J., Torgerson, D.J., Van Schoor, N.M., van Staa, T.P., Vilas, J.C., Wareham, N.J, Wright, N.C., Yoshimura, N., Zillikens, M.C., Zwart, M., Lorentzon, M., and Leslie, W.D.

Abstract

Summary: We describe the collection of cohorts together with the analysis plan for an update of the fracture risk prediction tool FRAX with respect to current and novel risk factors. The resource comprises 2,138,428 participants with a follow-up of approximately 20 million person-years and 116,117 documented incident major osteoporotic fractures. Introduction: The availability of the fracture risk assessment tool FRAX® has substantially enhanced the targeting of treatment to those at high risk of fracture with FRAX now incorporated into more than 100 clinical osteoporosis guidelines worldwide. The aim of this study is to determine whether the current algorithms can be further optimised with respect to current and novel risk factors. Methods: A computerised literature search was performed in PubMed from inception until May 17, 2019, to identify eligible cohorts for updating the FRAX coefficients. Additionally, we searched the abstracts of conference proceedings of the American Society for Bone and Mineral Research, European Calcified Tissue Society and World Congress of Osteoporosis. Prospective cohort studies with data on baseline clinical risk factors and incident fractures were eligible. Results: Of the 836 records retrieved, 53 were selected for full-text assessment after screening on title and abstract. Twelve cohorts were deemed eligible and of these, 4 novel cohorts were identified. These cohorts, together with 60 previously identified cohorts, will provide the resource for constructing an updated version of FRAX comprising 2,138,428 participants with a follow-up of approximately 20 million person-years and 116,117 documented incident major osteoporotic fractures. For each known and candidate risk factor, multivariate hazard functions for hip fracture, major osteoporotic fracture and death will be tested using extended Poisson regression. Sex- and/or ethnicity-specific differences in the weights of the risk factors will be investigated. After meta-analyses of the cohort-specific beta coefficients for each risk factor, models comprising 10-year probability of hip and major osteoporotic fracture, with or without femoral neck bone mineral density, will be computed. Conclusions: These assembled cohorts and described models will provide the framework for an updated FRAX tool enabling enhanced assessment of fracture risk (PROSPERO (CRD42021227266)).

Published
2022

9. Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight

Author

Iurilli, M.L.C. Zhou, B. Bennett, J.E. Carrillo-Larco, R.M. Sophiea, M.K. Rodriguez-Martinez, A. Bixby, H. Solomon, B.D. Taddei, C. Danaei, G. Di Cesare, M. Stevens, G.A. Riley, L.M. Savin, S. Cowan, M.J. Bovet, P. Damasceno, A. Chirita-Emandi, A. Hayes, A.J. Ikeda, N. Jackson, R.T. Khang, Y.-H. Laxmaiah, A. Liu, J. Miranda, J.J. Saidi, O. Sebert, S. Sorić, M. Starc, G. Gregg, E.W. Abarca-Gómez, L. Abdeen, Z.A. Abdrakhmanova, S. Ghaffar, S.A. Rahim, H.F.A. Abu-Rmeileh, N.M. Garba, J.A. Acosta-Cazares, B. Adams, R.J. Aekplakorn, W. Afsana, K. Afzal, S. Agdeppa, I.A. Aghazadeh-Attari, J. Aguilar-Salinas, C.A. Agyemang, C. Ahmad, M.H. Ahmad, N.A. Ahmadi, A. Ahmadi, N. Ahmed, S.H. Ahrens, W. Aitmurzaeva, G. Ajlouni, K. Al-Hazzaa, H.M. Al-Lahou, B. Al-Raddadi, R. Alarouj, M. AlBuhairan, F. AlDhukair, S. Ali, M.M. Alkandari, A. Alkerwi, A. Allin, K. Alvarez-Pedrerol, M. Aly, E. Amarapurkar, D.N. Amiri, P. Amougou, N. Amouyel, P. Andersen, L.B. Anderssen, S.A. Ängquist, L. Anjana, R.M. Ansari-Moghaddam, A. Aounallah-Skhiri, H. Araújo, J. Ariansen, I. Aris, T. Arku, R.E. Arlappa, N. Aryal, K.K. Aspelund, T. Assah, F.K. Assunção, M.C.F. Aung, M.S. Auvinen, J. Mária Avdicová Avi, S. Azevedo, A. Azimi-Nezhad, M. Azizi, F. Azmin, M. Babu, B.V. Bæksgaard Jørgensen, M. Baharudin, A. Bahijri, S. Baker, J.L. Balakrishna, N. Bamoshmoosh, M. Banach, M. Bandosz, P. Banegas, J.R. Baran, J. Barbagallo, C.M. Barceló, A. Barkat, A. Barros, A.J.D. Barros, M.V.G. Basit, A. Bastos, J.L.D. Bata, I. Batieha, A.M. Batista, R.L. Battakova, Z. Batyrbek, A. Baur, L.A. Beaglehole, R. Bel-Serrat, S. Belavendra, A. Romdhane, H.B. Benedics, J. Benet, M. Bergh, I.H. Berkinbayev, S. Bernabe-Ortiz, A. Bernotiene, G. Bettiol, H. Bezerra, J. Bhagyalaxmi, A. Bharadwaj, S. Bhargava, S.K. Bhutta, Z.A. Bi, H. Bi, Y. Bia, D. Lele, E.C.B. Bikbov, M.M. Bista, B. Bjelica, D.J. Bjerregaard, P. Bjertness, E. Bjertness, M.B. Björkelund, C. Bloch, K.V. Blokstra, A. Bo, S. Bobak, M. Boddy, L.M. Boehm, B.O. Boeing, H. Boggia, J.G. Bogova, E. Boissonnet, C.P. Bojesen, S.E. Bonaccio, M. Bongard, V. Bonilla-Vargas, A. Bopp, M. Borghs, H. Braeckevelt, L. Braeckman, L. Bragt, M.C.E. Brajkovich, I. Branca, F. Breckenkamp, J. Breda, J. Brenner, H. Brewster, L.M. Brian, G.R. Brinduse, L. Brophy, S. Bruno, G. Bueno-de-Mesquita, H.B. Bugge, A. Buoncristiano, M. Burazeri, G. Burns, C. de León, A.C. Cacciottolo, J. Cai, H. Cama, T. Cameron, C. Camolas, J. Can, G. Candido, A.P.C. Cañete, F. Capanzana, M.V. Capková, N. Capuano, E. Capuano, V. Cardol, M. Cardoso, V.C. Carlsson, A.C. Carmuega, E. Carvalho, J. Casajús, J.A. Casanueva, F.F. Celikcan, E. Censi, L. Cervantes-Loaiza, M. Cesar, J.A. Chamukuttan, S. Chan, A.W. Chan, Q. Chaturvedi, H.K. Chaturvedi, N. Rahim, N.C.A. Chee, M.L. Chen, C.-J. Chen, F. Chen, H. Chen, S. Chen, Z. Cheng, C.-Y. Cheraghian, B. Chetrit, A. Chikova-Iscener, E. Chiolero, A. Chiou, S.-T. Chirlaque, M.-D. Cho, B. Christensen, K. Christofaro, D.G. Chudek, J. Cifkova, R. Cilia, M. Cinteza, E. Claessens, F. Clarke, J. Clays, E. Cohen, E. Concin, H. Confortin, S.C. Cooper, C. Coppinger, T.C. Corpeleijn, E. Costanzo, S. Cottel, D. Cowell, C. Craig, C.L. Crampin, A.C. Crujeiras, A.B. Csilla, S. Cucu, A.M. Cui, L. Cureau, F.V. Czenczek-Lewandowska, E. D’Arrigo, G. d’Orsi, E. Dacica, L. Dal Re Saavedra, M.A. Dallongeville, J. Damsgaard, C.T. Dankner, R. Dantoft, T.M. Dasgupta, P. Dastgiri, S. Dauchet, L. Davletov, K. De Backer, G. De Bacquer, D. de Gaetano, G. De Henauw, S. de Oliveira, P.D. De Ridder, D. De Ridder, K. de Rooij, S.R. De Smedt, D. Deepa, M. Deev, A.D. DeGennaro, V., Jr Dehghan, A. Delisle, H. Delpeuch, F. Demarest, S. Dennison, E. Dereń, K. Deschamps, V. Dhimal, M. Di Castelnuovo, A.F. Dias-da-Costa, J.S. Díaz-Sánchez, M.E. Diaz, A. Dika, Z. Djalalinia, S. Djordjic, V. Do, H.T.P. Dobson, A.J. Donati, M.B. Donfrancesco, C. Donoso, S.P. Döring, A. Dorobantu, M. Dorosty, A.R. Doua, K. Dragano, N. Drygas, W. Duan, J.L. Duante, C.A. Duboz, P. Duda, R.B. Duleva, V. Dulskiene, V. Dumith, S.C. Dushpanova, A. Dzerve, V. Dziankowska-Zaborszczyk, E. Eddie, R. Eftekhar, E. Egbagbe, E.E. Eggertsen, R. Eghtesad, S. Eiben, G. Ekelund, U. El-Khateeb, M. Ati, J.E. Eldemire-Shearer, D. Eliasen, M. Elliott, P. Engle-Stone, R. Enguerran, M. Erasmus, R.T. Erbel, R. Erem, C. Eriksen, L. Eriksson, J.G. Escobedo-de la Peña, J. Eslami, S. Esmaeili, A. Evans, A. Faeh, D. Fakhretdinova, A.A. Fall, C.H. Faramarzi, E. Farjam, M. Sant’Angelo, V.F. Farzadfar, F. Fattahi, M.R. Fawwad, A. Felix-Redondo, F.J. Ferguson, T.S. Fernandes, R.A. Fernández-Bergés, D. Ferrante, D. Ferrao, T. Ferrari, M. Ferrario, M.M. Ferreccio, C. Ferrer, E. Ferrieres, J. Figueiró, T.H. Fijalkowska, A. Fink, G. Fischer, K. Foo, L.H. Forsner, M. Fouad, H.M. Francis, D.K. Maria do Carmo Franco Frikke-Schmidt, R. Frontera, G. Fuchs, F.D. Fuchs, S.C. Fujiati, I.I. Fujita, Y. Fumihiko, M. Furusawa, T. Gaciong, Z. Gafencu, M. Galbarczyk, A. Galenkamp, H. Galeone, D. Galfo, M. Galvano, F. Gao, J. Garcia-de-la-Hera, M. García-Solano, M. Gareta, D. Garnett, S.P. Gaspoz, J.-M. Gasull, M. Gaya, A.C.A. Gaya, A.R. Gazzinelli, A. Gehring, U. Geiger, H. Geleijnse, J.M. Ghanbari, A. Ghasemi, E. Gheorghe-Fronea, O.-F. Giampaoli, S. Gianfagna, F. Gill, T.K. Giovannelli, J. Gironella, G. Giwercman, A. Gkiouras, K. Godos, J. Gogen, S. Goldberg, M. Goldsmith, R.A. Goltzman, D. Gómez, S.F. Gomula, A. da Silva, B.G.C. Gonçalves, H. Gonzalez-Chica, D.A. Gonzalez-Gross, M. González-Leon, M. González-Rivas, J.P. González-Villalpando, C. González-Villalpando, M.-E. Gonzalez, A.R. Gottrand, F. Graça, A.P. Graff-Iversen, S. Grafnetter, D. Grajda, A. Grammatikopoulou, M.G. Gregor, R.D. Grodzicki, T. Grøholt, E.K. Grøntved, A. Grosso, G. Gruden, G. Gu, D. Gualdi-Russo, E. Guallar-Castillón, P. Gualtieri, A. Gudmundsson, E.F. Gudnason, V. Guerrero, R. Guessous, I. Guimaraes, A.L. Gulliford, M.C. Gunnlaugsdottir, J. Gunter, M.J. Guo, X.-H. Guo, Y. Gupta, P.C. Gupta, R. Gureje, O. Gurzkowska, B. Gutiérrez-González, E. Gutierrez, L. Gutzwiller, F. Ha, S. Hadaegh, F. Hadjigeorgiou, C.A. Haghshenas, R. Hakimi, H. Halkjær, J. Hambleton, I.R. Hamzeh, B. Hange, D. Hanif, A.A.M. Hantunen, S. Hao, J. Kumar, R.H. Hashemi-Shahri, S.M. Hassapidou, M. Hata, J. Haugsgjerd, T. He, J. He, Y. He, Y. Heidinger-Felso, R. Heinen, M. Hejgaard, T. Hendriks, M.E. dos Santos Henrique, R. Henriques, A. Cadena, L.H. Herrala, S. Herrera, V.M. Herter-Aeberli, I. Heshmat, R. Hill, A.G. Ho, S.Y. Ho, S.C. Hobbs, M. Holdsworth, M. Homayounfar, R. Homs, C. Hopman, W.M. Horimoto, A.R.V.R. Hormiga, C.M. Horta, B.L. Houti, L. Howitt, C. Htay, T.T. Htet, A.S. Htike, M.M.T. Hu, Y. Huerta, J.M. Huhtaniemi, I.T. Huiart, L. Petrescu, C.H. Huisman, M. Husseini, A. Huu, C.N. Huybrechts, I. Hwalla, N. Hyska, J. Iacoviello, L. Ibarluzea, J.M. Ibrahim, M.M. Wong, N.I. Ikram, M.A. Iotova, V. Irazola, V.E. Ishida, T. Islam, M. Islam, S.M.S. Iwasaki, M. Jacobs, J.M. Jaddou, H.Y. Jafar, T. James, K. Jamil, K.M. Jamrozik, K. Janszky, I. Janus, E. Jarani, J. Jarvelin, M.-R. Jasienska, G. Jelakovic, A. Jelakovic, B. Jennings, G. Jha, A.K. Jiang, C.Q. Jimenez, R.O. Jöckel, K.-H. Joffres, M. Johansson, M. Jokelainen, J.J. Jonas, J.B. Jonnagaddala, J. Jørgensen, T. Joshi, P. Joukar, F. Jovic, D.P. Jóźwiak, J.J. Juolevi, A. Jurak, G. Simina, I.J. Juresa, V. Kaaks, R. Kaducu, F.O. Kafatos, A. Kajantie, E.O. Kalmatayeva, Z. Kalter-Leibovici, O. Kameli, Y. Kampmann, F.B. Kanala, K.R. Kannan, S. Kapantais, E. Karakosta, A. Kårhus, L.L. Karki, K.B. Katibeh, M. Katz, J. Katzmarzyk, P.T. Kauhanen, J. Kaur, P. Kavousi, M. Kazakbaeva, G.M. Keil, U. Boker, L.K. Keinänen-Kiukaanniemi, S. Kelishadi, R. Kelleher, C. Kemper, H.C.G. Kengne, A.P. Keramati, M. Kerimkulova, A. Kersting, M. Key, T. Khader, Y.S. Khalili, D. Khaw, K.-T. Kheiri, B. Kheradmand, M. Khosravi, A. Khouw, I.M.S.L. Kiechl-Kohlendorfer, U. Kiechl, S. Killewo, J. Kim, D.W. Kim, H.C. Kim, J. Kindblom, J.M. Klakk, H. Klimek, M. Klimont, J. Klumbiene, J. Knoflach, M. Koirala, B. Kolle, E. Kolsteren, P. König, J. Korpelainen, R. Korrovits, P. Korzycka, M. Kos, J. Koskinen, S. Kouda, K. Kovacs, V.A. Kowlessur, S. Koziel, S. Kratenova, J. Kratzer, W. Kriemler, S. Kristensen, P.L. Krokstad, S. Kromhout, D. Kruger, H.S. Kubinova, R. Kuciene, R. Kujala, U.M. Kujundzic, E. Kulaga, Z. Kumar, R.K. Kunešová, M. Kurjata, P. Kusuma, Y.S. Kuulasmaa, K. Kyobutungi, C. La, Q.N. Laamiri, F.Z. Laatikainen, T. Lachat, C. Laid, Y. Lam, T.H. Lambrinou, C.-P. Landais, E. Lanska, V. Lappas, G. Larijani, B. Latt, T.S. Lauria, L. Lazo-Porras, M. Le Coroller, G. Bao, K.L.N. Le Port, A. Le, T.D. Lee, J. Lee, J. Lee, P.H. Lehmann, N. Lehtimäki, T. Lemogoum, D. Levitt, N.S. Li, Y. Liivak, M. Lilly, C.L. Lim, W.-Y. Lima-Costa, M.F. Lin, H.-H. Lin, X. Lin, Y.-T. Lind, L. Linneberg, A. Lissner, L. Litwin, M. Liu, L. Lo, W.-C. Loit, H.-M. Long, K.Q. Lopes, L. Lopes, O. Lopez-Garcia, E. Lopez, T. Lotufo, P.A. Lozano, J.E. Lukrafka, J.L. Luksiene, D. Lundqvist, A. Lundqvist, R. Lunet, N. Lunogelo, C. Lustigová, M. Łuszczki, E. Ma, G. Ma, J. Ma, X. Machado-Coelho, G.L.L. Machado-Rodrigues, A.M. Macieira, L.M. Madar, A.A. Maggi, S. Magliano, D.J. Magnacca, S. Magriplis, E. Mahasampath, G. Maire, B. Majer, M. Makdisse, M. Mäki, P. Malekzadeh, F. Malekzadeh, R. Malhotra, R. Rao, K.M. Malyutina, S.K. Maniego, L.V. Manios, Y. Mann, J.I. Mansour-Ghanaei, F. Manzato, E. Margozzini, P. Markaki, A. Markey, O. Ioannidou, E.M. Marques-Vidal, P. Marques, L.P. Marrugat, J. Martin-Prevel, Y. Martin, R. Martorell, R. Martos, E. Maruszczak, K. Marventano, S. Mascarenhas, L.P. Masoodi, S.R. Mathiesen, E.B. Mathur, P. Matijasevich, A. Matsha, T.E. Mavrogianni, C. Mazur, A. Mbanya, J.C.N. McFarlane, S.R. McGarvey, S.T. McKee, M. McLachlan, S. McLean, R.M. McLean, S.B. McNulty, B.A. Benchekor, S.M. Medzioniene, J. Mehdipour, P. Mehlig, K. Mehrparvar, A.H. Meirhaeghe, A. Meisfjord, J. Meisinger, C. Menezes, A.M.B. Menon, G.R. Mensink, G.B.M. Menzano, M.T. Mereke, A. Meshram, I.I. Metspalu, A. Meyer, H.E. Mi, J. Michaelsen, K.F. Michels, N. Mikkel, K. Milkowska, K. Miller, J.C. Minderico, C.S. Mini, G.K. Miquel, J.F. Mirjalili, M.R. Mirkopoulou, D. Mirrakhimov, E. Mišigoj-Durakovic, M. Mistretta, A. Mocanu, V. Modesti, P.A. Moghaddam, S.S. Mohajer, B. Mohamed, M.K. Mohamed, S.F. Mohammad, K. Mohammadi, Z. Mohammadifard, N. Mohammadpourhodki, R. Mohan, V. Mohanna, S. Yusoff, M.F.M. Mohebbi, I. Mohebi, F. Moitry, M. Molbo, D. Møllehave, L.T. Møller, N.C. Molnár, D. Momenan, A. Mondo, C.K. Monroy-Valle, M. Monterrubio-Flores, E. Monyeki, K.D.K. Moon, J.S. Moosazadeh, M. Moreira, L.B. Morejon, A. Moreno, L.A. Morgan, K. Morin, S.N. Mortensen, E.L. Moschonis, G. Mossakowska, M. Mostafa, A. Mota-Pinto, A. Mota, J. Motlagh, M.E. Motta, J. Moura-dos-Santos, M.A. Mridha, M.K. Msyamboza, K.P. Mu, T.T. Muc, M. Mugoša, B. Muiesan, M.L. Mukhtorova, P. Müller-Nurasyid, M. Murphy, N. Mursu, J. Murtagh, E.M. Musa, K.I. Milanovic, S.M. Musil, V. Mustafa, N. Nabipour, I. Naderimagham, S. Nagel, G. Naidu, B.M. Najafi, F. Nakamura, H. Námešná, J. Nang, E.E.K. Nangia, V.B. Nankap, M. Narake, S. Nardone, P. Nauck, M. Neal, W.A. Nejatizadeh, A. Nekkantti, C. Nelis, K. Nelis, L. Nenko, I. Neovius, M. Nervi, F. Nguyen, C.T. Nguyen, N.D. Nguyen, Q.N. Nieto-Martínez, R.E. Nikitin, Y.P. Ning, G. Ninomiya, T. Nishtar, S. Noale, M. Noboa, O.A. Nogueira, H. Norat, T. Nordendahl, M. Nordestgaard, B.G. Noto, D. Nowak-Szczepanska, N. Al Nsour, M. Nuhoglu, I. Nurk, E. O’Neill, T.W. O’Reilly, D. Obreja, G. Ochimana, C. Ochoa-Avilés, A.M. Oda, E. Oh, K. Ohara, K. Ohlsson, C. Ohtsuka, R. Olafsson, O. Olinto, M.T.A. Oliveira, I.O. Omar, M.A. Onat, A. Ong, S.K. Ono, L.M. Ordunez, P. Ornelas, R. Ortiz, A.P. Ortiz, P.J. Osler, M. Osmond, C. Ostojic, S.M. Ostovar, A. Otero, J.A. Overvad, K. Owusu-Dabo, E. Paccaud, F.M. Padez, C. Pagkalos, I. Pahomova, E. de Paiva, K.M. Pajak, A. Palli, D. Palloni, A. Palmieri, L. Pan, W.-H. Panda-Jonas, S. Pandey, A. Panza, F. Papandreou, D. Park, S.-W. Park, S. Parnell, W.R. Parsaeian, M. Pascanu, I.M. Pasquet, P. Patel, N.D. Pecin, I. Pednekar, M.S. Peer, N. Pei, G. Peixoto, S.V. Peltonen, M. Pereira, A.C. Peres, M.A. Pérez-Farinós, N. Pérez, C.M. Peterkova, V. Peters, A. Petersmann, A. Petkeviciene, J. Petrauskiene, A. Pettenuzzo, E. Peykari, N. Pham, S.T. Pichardo, R.N. Pierannunzio, D. Pigeot, I. Pikhart, H. Pilav, A. Pilotto, L. Pistelli, F. Pitakaka, F. Piwonska, A. Pizarro, A.N. Plans-Rubió, P. Poh, B.K. Pohlabeln, H. Pop, R.M. Popovic, S.R. Porta, M. Posch, G. Poudyal, A. Poulimeneas, D. Pouraram, H. Pourfarzi, F. Pourshams, A. Poustchi, H. Pradeepa, R. Price, A.J. Price, J.F. Providencia, R. Puder, J.J. Pudule, I. Puhakka, S.E. Puiu, M. Punab, M. Qasrawi, R.F. Qorbani, M. Bao, T.Q. Radic, I. Radisauskas, R. Rahimikazerooni, S. Rahman, M. Rahman, M. Raitakari, O. Raj, M. Rakhimova, E. Rakhmatulloev, S. Rakovac, I. Rao, S.R. Ramachandran, A. Ramke, J. Ramos, E. Ramos, R. Rampal, L. Rampal, S. Rarra, V. Rascon-Pacheco, R.A. Rasmussen, M. Rech, C.R. Redon, J. Reganit, P.F.M. Regecová, V. Revilla, L. Rezaianzadeh, A. Ribas-Barba, L. Ribeiro, R. Riboli, E. Richter, A. Rigo, F. Rinaldo, N. de Wit, T.F.R. Rito, A. Ritti-Dias, R.M. Rivera, J.A. Robitaille, C. Roccaldo, R. Rodrigues, D. Rodríguez-Artalejo, F. del Cristo Rodriguez-Perez, M. Rodríguez-Villamizar, L.A. Roggenbuck, U. Rojas-Martinez, R. Rojroongwasinkul, N. Romaguera, D. Romeo, E.L. Rosario, R.V. Rosengren, A. Rouse, I. Roy, J.G.R. Rubinstein, A. Rühli, F.J. Ruidavets, J.-B. Ruiz-Betancourt, B.S. Ruiz-Castell, M. Moreno, E.R. Rusakova, I.A. Jonsson, K.R. Russo, P. Rust, P. Rutkowski, M. Sabanayagam, C. Sacchini, E. Sachdev, H.S. Sadjadi, A. Safarpour, A.R. Safiri, S. Saki, N. Salanave, B. Martinez, E.S. Salmerón, D. Salomaa, V. Salonen, J.T. Salvetti, M. Samoutian, M. Sánchez-Abanto, J. Sans, S. Marina, L.S. Santos, D.A. Santos, I.S. Santos, L.C. Santos, M.P. Santos, O. Santos, R. Sanz, S.S. Saramies, J.L. Sardinha, L.B. Sarrafzadegan, N. Sathish, T. Saum, K.-U. Savva, S. Savy, M. Sawada, N. Sbaraini, M. Scazufca, M. Schaan, B.D. Rosario, A.S. Schargrodsky, H. Schienkiewitz, A. Schipf, S. Schmidt, C.O. Schmidt, I.M. Schnohr, P. Schöttker, B. Schramm, S. Schramm, S. Schröder, H. Schultsz, C. Schutte, A.E. Sein, A.A. Selamat, R. Sember, V. Sen, A. Senbanjo, I.O. Sepanlou, S.G. Sequera, V. Serra-Majem, L. Servais, J. Ševcíková, L. Shalnova, S.A. Shamah-Levy, T. Shamshirgaran, M. Shanthirani, C.S. Sharafkhah, M. Sharma, S.K. Shaw, J.E. Shayanrad, A. Shayesteh, A.A. Shengelia, L. Shi, Z. Shibuya, K. Shimizu-Furusawa, H. Shin, D.W. Shirani, M. Shiri, R. Shrestha, N. Si-Ramlee, K. Siani, A. Siantar, R. Sibai, A.M. Silva, A.M. Silva, D.A.S. Simon, M. Simons, J. Simons, L.A. Sjöberg, A. Sjöström, M. Skodje, G. Slowikowska-Hilczer, J. Slusarczyk, P. Smeeth, L. So, H.-K. Soares, F.C. Sobek, G. Sobngwi, E. Sodemann, M. Söderberg, S. Soekatri, M.Y.E. Soemantri, A. Sofat, R. Solfrizzi, V. Somi, M.H. Sonestedt, E. Song, Y. Sørensen, T.I.A. Sørgjerd, E.P. Jérome, C.S. Soto-Rojas, V.E. Soumaré, A. Sovic, S. Sparboe-Nilsen, B. Sparrenberger, K. Spinelli, A. Spiroski, I. Staessen, J.A. Stamm, H. Stathopoulou, M.G. Staub, K. Stavreski, B. Steene-Johannessen, J. Stehle, P. Stein, A.D. Stergiou, G.S. Stessman, J. Stevanovic, R. Stieber, J. Stöckl, D. Stocks, T. Stokwiszewski, J. Stoyanova, E. Stratton, G. Stronks, K. Strufaldi, M.W. Sturua, L. Suárez-Medina, S. Suka, M. Sun, C.-A. Sundström, J. Sung, Y.-T. Sunyer, J. Suriyawongpaisal, P. Swinburn, B.A. Sy, R.G. Syddall, H.E. Sylva, R.C. Szklo, M. Szponar, L. Tai, E.S. Tammesoo, M.-L. Tamosiunas, A. Tan, E.J. Tang, X. Tanrygulyyeva, M. Tanser, F. Tao, Y. Tarawneh, M.R. Tarp, J. Tarqui-Mamani, C.B. Braunerová, R.T. Taylor, A. Taylor, J. Tchibindat, F. Tebar, W.R. Tell, G.S. Tello, T. Tham, Y.C. Thankappan, K.R. Theobald, H. Theodoridis, X. Thijs, L. Thomas, N. Thuesen, B.H. Tichá, L. Timmermans, E.J. Tjonneland, A. Tolonen, H.K. Tolstrup, J.S. Topbas, M. Topór-Madry, R. Torheim, L.E. Tormo, M.J. Tornaritis, M.J. Torrent, M. Torres-Collado, L. Toselli, S. Touloumi, G. Traissac, P. Tran, T.T.-H. Trichopoulos, D. Trichopoulou, A. Trinh, D.T.H. Trivedi, A. Tshepo, L. Tsigga, M. Tsugane, S. Tuliakova, A.M. Tulloch-Reid, M.K. Tullu, F. Tuomainen, T.-P. Tuomilehto, J. Turley, M.L. Twig, G. Tynelius, P. Tzotzas, T. Tzourio, C. Ueda, P. Ugel, E. Ukoli, F.A.M. Ulmer, H. Unal, B. Usupova, Z. Uusitalo, H.M.T. Uysal, N. Vaitkeviciute, J. Valdivia, G. Vale, S. Valvi, D. van Dam, R.M. Van der Heyden, J. van der Schouw, Y.T. Van Herck, K. Van Minh, H. Van Schoor, N.M. van Valkengoed, I.G.M. Vanderschueren, D. Vanuzzo, D. Varbo, A. Varela-Moreiras, G. Varona-Pérez, P. Vasan, S.K. Vega, T. Veidebaum, T. Velasquez-Melendez, G. Velika, B. Veronesi, G. Verschuren, W.M.M. Victora, C.G. Viegi, G. Viet, L. Villalpando, S. Vineis, P. Vioque, J. Virtanen, J.K. Visser, M. Visvikis-Siest, S. Viswanathan, B. Vladulescu, M. Vlasoff, T. Vocanec, D. Vollenweider, P. Völzke, H. Voutilainen, A. Voutilainen, S. Vrijheid, M. Vrijkotte, T.G.M. Wade, A.N. Wagner, A. Waldhör, T. Walton, J. Wambiya, E.O.A. Bebakar, A.M.W. Mohamud, W.N.W. de Souza Wanderley Júnior, R. Wang, M.-D. Wang, N. Wang, Q. Wang, X. Wang, Y.X. Wang, Y.-W. Wannamethee, S.G. Wareham, N. Weber, A. Wedderkopp, N. Weerasekera, D. Weghuber, D. Wei, W. Weres, A. Werner, B. Whincup, P.H. Widhalm, K. Widyahening, I.S. Wiecek, A. Wilks, R.J. Willeit, J. Willeit, P. Williams, J. Wilsgaard, T. Wojtyniak, B. Wong-McClure, R.A. Wong, A. Wong, J.E. Wong, T.Y. Woo, J. Woodward, M. Wu, F.C. Wu, J. Wu, L.J. Wu, S. Xu, H. Xu, L. Yaacob, N.A. Yamborisut, U. Yan, W. Yang, L. Yang, X. Yang, Y. Yardim, N. Yaseri, M. Yasuharu, T. Ye, X. Yiallouros, P.K. Yoosefi, M. Yoshihara, A. You, Q.S. You, S.-L. Younger-Coleman, N.O. Yusof, S.M. Yusoff, A.F. Zaccagni, L. Zafiropulos, V. Zainuddin, A.A. Zakavi, S.R. Zamani, F. Zambon, S. Zampelas, A. Zamrazilová, H. Zapata, M.E. Zargar, A.H. Zaw, K.K. Zdrojewski, T. Zejglicova, K. Vrkic, T.Z. Zeng, Y. Zhang, L. Zhang, Z.-Y. Zhao, D. Zhao, M.-H. Zhao, W. Zhen, S. Zheng, W. Zheng, Y. Zholdin, B. Zhou, M. Zhu, D. Zins, M. Zitt, E. Zocalo, Y. Cisneros, J.Z. Zuziak, M. Ezzati, M. Filippi, S. NCD Risk Factor Collaboration (NCD-RisC)

Subjects
nutritional and metabolic diseases, sense organs, skin and connective tissue diseases
Abstract

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions. © Copyright.

Published
2021

13. Determinants of incident vertebral fracture in men and women: results from the European Prospective Osteoporosis Study (EPOS)

Author

Roy, D.K., O'Neill, T.W., Finn, J.D., Lunt, M., Silman, A.J., Felsenberg, D., Armbrecht, G., Banzer, D., Benevolenskaya, L.I., Bhalla, A., Bruges Armas, J., Cannata, J.B., Cooper, C., Dequeker, J., Diaz, M.N., Eastell, R., Yershova, O.B., Felsch, B., Gowin, W., Havelka, S., Hoszowski, K., Ismail, A.A., Jajic, I., Janott, I., Johnell, O., Kanis, J.A., Kragl, G., Lopez Vaz, A., Lorenc, R., Lyritis, G., Masaryk, P., Matthis, C., Miazgowski, T., Gennari, C., Pols, H.A.P., Poor, G., Raspe, H.H., Reid, D.M., Reisinger, W., Scheidt-Nave, C., Stepan, J.J., Todd, C.J., Weber, K., Woolf, A.D., and Reeve, J.

Published
2003
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14. Back pain, disability, and radiographic vertebral fracture in European women: a prospective study

Author

O'Neill, T.W., Cockerill, W., Matthis, C., Raspe, H.H., Lunt, M., Cooper, C., Banzer, D., Cannata, J.B., Naves, M., Felsch, B., Felsenberg, D., Janott, J., Johnell, O., Kanis, J.A., Kragl, G., Lopes Vaz, A., Lyritis, G., Masaryk, P., Poor, G., Reid, D.M., Reisinger, W., Scheidt-Nave, C., Stepan, J.J., Todd, C.J., Woolf, A.D., Reeve, J., and Silman, A.J.

Subjects
Backache -- Complications and side effects, Backache -- Care and treatment, Disabled women -- Physiological aspects, Disabled women -- Health aspects, Disabled women -- Care and treatment, Fractures -- Causes of, Fractures -- Diagnosis, Radiography, Medical -- Usage, Vertebrae -- Injuries, Health
Abstract

Byline: T. W. O'Neill (1), W. Cockerill (1), C. Matthis (2), H. H. Raspe (2), M. Lunt (1), C. Cooper (3), D. Banzer (4), J. B. Cannata (5), M. Naves (5), B. Felsch (6), D. Felsenberg (7), J. Janott (8), O. Johnell (9), J. A. Kanis (10), G. Kragl (11), A. Lopes Vaz (12), G. Lyritis (13), P. Masaryk (14), G. Poor (15), D. M. Reid (16), W. Reisinger (17), C. Scheidt-Nave (18), J. J. Stepan (19), C. J. Todd (20), A. D. Woolf (21), J. Reeve (22), A. J. Silman (1) Keywords: Back pain; Disability; Prospective study; Vertebral fracture Abstract: Vertebral fractures are associated with back pain and disability. There are, however, few prospective data looking at back pain and disability following identification of radiographic vertebral fracture. The aim of this analysis was to determine the impact of radiographically identified vertebral fracture on the subsequent occurrence of back pain and disability. Women aged 50 years and over were recruited from population registers in 18 European centers for participation in the European Prospective Osteoporosis Study. Participants completed an interviewer-administered questionnaire which included questions about back pain in the past year and various activities of daily living, and they had lateral spine radiographs performed. Participants in these centers were followed prospectively and had repeat spine radiographs performed a mean of 3.7 years later. In addition they completed a questionnaire with the same baseline questions concerning back pain and activities of daily living. The presence of prevalent and incident vertebral fracture was defined using established morphometric criteria. The data were analyzed using logistic regression with back pain or disability (present or absent) at follow-up as the outcome variable with adjustment made for the baseline value of the variable. The study included 2,260 women, mean age 62.2 years. The mean time between baseline and follow-up survey was 5.0 years. Two hundred and forty participants had prevalent fractures at the baseline survey, and 85 developed incident fractures during follow-up. After adjustment for age, center, and the baseline level of disability, compared with those without baseline prevalent fracture, those with a prevalent fracture (odds ratio [OR]=1.4 95% confidence interval [CI] 1.0 to 2.0) or an incident fracture (OR=1.7 95% CI, 0.9 to 3.2) were more likely to report disability at follow-up, though the confidence intervals embraced unity. Those with both a prevalent and incident fracture, however, were significantly more likely to report disability at follow-up (OR=3.1 95% CI, 1.4 to 7.0). After adjustment for age, center, and frequency of back pain at baseline, compared with those without baseline vertebral fracture, those with a prevalent fracture were no more likely to report back pain at follow-up (OR=1.2 95%CI, 0.8 to 1.7). There was a small increased risk among those with a preexisting fracture who had sustained an incident fracture during follow-up (OR=1.6 95%CI, 0.6 to 4.1) though the confidence intervals embraced unity. In conclusion, although there was no significant increase in the level of back pain an average of 5 years following identification of radiographic vertebral fracture, women who suffered a further fracture during follow-up experienced substantial levels of disability with impairment in key physical functions of independent living. Author Affiliation: (1) ARC Epidemiology Research Unit, University of Manchester, Manchester, M13 9PT, UK (2) Institute for Social Medicine, Medical University of Lubeck, Lubeck, Germany (3) MRC Environmental Epidemiology Unit, Southampton General Hospital, Southampton, UK (4) Department of Radiology, Behring Hospital, Berlin, Germany (5) Asturia General Hospital, Oviedo, Spain (6) Clinic for Internal Medicine, Jena, Germany (7) Department of Radiology and Nuclear Medicine, Free University, Berlin, Germany (8) Ruhr University, Bochum, Germany (9) Department of Orthopedics, Lund University, Malmo, Sweden (10) Centre for Metabolic Bone Disease, Sheffield, UK (11) Medical Academy, Erfurt, Germany (12) Hospital de San Joao, Oporto, Portugal (13) Laboratory for the Research of Musculoskeletal System, University of Athens, Athens, Greece (14) Institute of Rheumatic Diseases, Piestany, Slovakia (15) National Institute of Rheumatology and Physiotherapy, Budapest, Hungary (16) Department of Medicine and Therapeutics, University of Aberdeen, Aberdeen, UK (17) Institute for Diagnostic Radiology, Humboldt University, Berlin, Germany (18) Department of General Practice, University of Goettingen, Goettingen, Germany (19) Department of Medicine, Charles University, Prague, Czech Republic (20) School of Nursing, Midwifery and Health Visiting, University of Manchester, Manchester, UK (21) Department of Rheumatology, Royal Cornwall Hospital, Truro, UK (22) University Department of Medicine and Institute of Public Health, Cambridge, UK Article History: Registration Date: 12/02/2004 Received Date: 27/11/2003 Accepted Date: 11/02/2004 Online Date: 12/05/2004

Published
2004

15. Incidence of Limb Fracture across Europe: Results from the European Prospective Osteoporosis Study (EPOS)

Author

Ismail, A.A., Pye, S.R., Cockerill, W.C., Lunt, M., Silman, A.J., Reeve, J., Banzer, D., Benevolenskaya, L.I., Bhalla, A., Bruges Armas, J., Cannata, J.B., Cooper, C., Delmas, P.D., Dequeker, J., Dilsen, G., Falch, J.A., Felsch, B., Felsenberg, D., Finn, J.D., Gennari, C., Hoszowski, K., Jajic, I., Janott, J., Johnell, O., Kanis, J.A., Kragl, G., Lopez Vaz, A., Lorenc, R., Lyritis, G., Marchand, F., Masaryk, P., Matthis, C., Miazgowski, T., Naves-Diaz, M., Pols, H.A.P., Poor, G., Rapado, A., Raspe, H.H., Reid, D. M., Reisinger, W., Scheidt-Nave, C., Stepan, J., Todd, C., Weber, K., Woolf, A.D., and O'Neill, T.W.

Subjects
Epidemiologic methods -- Usage, Fractures -- Distribution, Fractures -- Surveys, Osteoporosis -- Distribution, Osteoporosis -- Complications and side effects, Company distribution practices, Health
Abstract

Byline: A. A. Ismail (1), S. R. Pye (1), W. C. Cockerill (1), M. Lunt (1), A. J. Silman* (1), J. Reeve* (2), D. Banzer (3), L. I. Benevolenskaya (4), A. Bhalla (5), J. Bruges Armas (6), J. B. Cannata (7), C. Cooper (8), P. D. Delmas (9), J. Dequeker (10), G. Dilsen (11), J. A. Falch (12), B. Felsch (13), D. Felsenberg (14), J. D. Finn (1), C. Gennari (15), K. Hoszowski (16), I. Jajic (17), J. Janott (18), O. Johnell (19), J. A. Kanis (20), G. Kragl (21), A. Lopez Vaz (22), R. Lorenc (23), G. Lyritis (24), F. Marchand (25), P. Masaryk (26), C. Matthis (27), T. Miazgowski (28), M. Naves-Diaz (7), H. A. P. Pols (29), G. Poor (30), A. Rapado (31), H. H. Raspe (27), D. M. Reid (32), W. Reisinger (33), C. Scheidt-Nave (34), J. Stepan (35), C. Todd (36), K. Weber (37), A. D. Woolf (38), T. W. O'Neill (1) Keywords: Key words:Epidemiology -- Europe -- Incidence -- Limb fracture -- Osteoporosis Abstract: The aim of this population-based prospective study was to determine the incidence of limb fracture by site and gender in different regions of Europe. Men and women aged 50--79 years were recruited from population registers in 31 European centers. Subjects were invited to attend for an interviewer-administered questionnaire and lateral spinal radiographs. Subjects were subsequently followed up using an annual postal questionnaire which included questions concerning the occurrence of new fractures. Self-reported fractures were confirmed where possible by radiograph, attending physician or subject interview. There were 6451 men and 6936 women followed for a median of 3.0 years. During this time there were 140 incident limb fractures in men and 391 in women. The age-adjusted incidence of any limb fracture was 7.3/1000 person-years [pyrs] in men and 19 per 1000 pyrs in women, equivalent to a 2.5 times excess in women. Among women, the incidence of hip, humerus and distal forearm fracture, though not 'other' limb fracture, increased with age, while in men only the incidence of hip and humerus fracture increased with age. Among women, there was evidence of significant variation in the occurrence of hip, distal forearm and humerus fractures across Europe, with incidence rates higher in Scandinavia than in other European regions, though for distal forearm fracture the incidence in east Europe was similar to that observed in Scandinavia. Among men, there was no evidence of significant geographic variation in the occurrence of these fractures. This is the first large population-based study to characterize the incidence of limb fracture in men and women over 50 years of age across Europe. There are substantial differences in the descriptive epidemiology of limb fracture by region and gender. Author Affiliation: (1) ARC Epidemiology Unit, University of Manchester, Manchester, UK, GB (2) Strangeways Research Laboratories, Cambridge, UK, GB (3) Behring Hospital, Berlin, Germany, DE (4) Institute of Rheumatology, Moscow, Russia, RU (5) Royal National Hospital for Rheumatic Diseases, Bath, UK, GB (6) Hospital de Angra do Heroismo, Azores, Portugal, PT (7) Asturia General Hospital, Oviedo, Spain, ES (8) University of Southampton, Southampton General Hospital, Southampton, UK, GB (9) U. INSERM 403, Lyon, France, FR (10) University Hospital, Leuven, Belgium, BE (11) Medical Faculty, University of Istanbul, Istanbul, Turkey, TR (12) Aker Hospital, Oslo, Norway, NO (13) Clinic for Internal Medicine, Jena, Germany, DE (14) Department of Radiology and Nuclear Medicine, Free University, Berlin, Germany, DE (15) Institute of Clinical Medicine, University of Siena, Siena, Italy, IT (16) Medical Centre, Warsaw, Poland, PL (17) Clinical Hospital, Zagreb, Croatia, YU (18) Ruhr University, Bochum, Germany, DE (19) Lund University, MalmoA', Sweden, SE (20) Centre for Metabolic Bone Disease, Sheffield, UK, GB (21) Medical Academy, Erfurt, Germany, DE (22) Hospital de San Joao, Oporto, Portugal, PT (23) The Children Memorial Health Institute, Warsaw, Poland, PL (24) Laboratory for the Research of Musculoskeletal System, University of Athens, Athens, Greece, GR (25) Centre de Medecine SpecialiseA'e, Montceau-les-Mines, France, FR (26) Institute of Rheumatic Diseases, Piestany, Slovakia, CS (27) Institute of Social Medicine, Lubeck, Germany, DE (28) Academy of Medicine, Szczecin, Poland, PL (29) Department of Epidemiology and Department of Internal Medicine, Erasmus University, Rotterdam, The Netherlands, NL (30) National Institute of Rheumatology and Physiotherapy, Budapest, Hungary, HU (31) Faculty of Medicine, University of Madrid, Madrid, Spain, ES (32) Department of Medicine and Therapeutics, University of Aberdeen, Aberdeen, UK, GB (33) Institute for Diagnostic Radiology, Humboldt University, Berlin, Germany, DE (34) Institute of Social Medicine, University of Heidelberg, Heidelberg, Germany, DE (35) Department of Internal Medicine, Charles University, Prague, Czech Republic, CS (36) School of Nursing, Midwifery and Health Visiting, University of Manchester, Manchester, UK, GB (37) Department of Medicine, University Hospital, Graz, Austria, AT (38) Department of Rheumatology, Royal Cornwall Hospital, Truro, UK, GB Article note: Received: 23 October 2001 / Accepted: 31 January 2002

Published
2002

16. Incidence of Distal Forearm Fracture in British Men and Women

Author

O'Neill, T.W., Cooper, C., Finn, J.D., Lunt, M., Purdie, D., Reid, D.M., Rowe, R., Woolf, A.D., and Wallace, W.A.

Subjects
Fractures -- Risk factors, Osteoporosis -- Complications and side effects, Arm -- Injuries, Arm -- Risk factors, Health
Abstract

Byline: T. W. O'Neill (1), C. Cooper (2), J. D. Finn (1), M. Lunt (1), D. Purdie (3), D. M. Reid (4), R. Rowe (5), A. D. Woolf (6), W. A. Wallace (7) Keywords: Key words:Distal forearm fracture -- Epidemiology -- Incidence -- Osteoporosis Abstract: Fracture of the distal forearm is one of the most frequent osteoporotic fractures. However, there are few data concerning its incidence in Britain. The aim of this study was to determine the incidence of distal forearm fracture in adult British men and women. Six centers took part in the study: Aberdeen, Hull, Nottingham, Portsmouth, Southampton and Truro. At each center, men and women aged 35 years and over with an incident distal forearm fracture and who resided in the catchment area of the main hospital at that center, were identified during a 12 month period. Incident fractures were identified from all possible point-of-contact sources in each locality, including accident and emergency records, fracture clinics, ward listings and plaster room registers. The population at risk was defined geographically according to postcode and the denominator obtained from 1991 census data mapped to these postcodes. During the 12 month study period, 3161 individuals with distal forearm fracture were identified. The age-adjusted incidence, age 35 years and over, was 36.8/10000 person-years in women and 9.0/10000 person-years in men. In women, the incidence of fracture increased progressively with age from the perimenopausal period, while in men the incidence remained low until later life. Fractures were more frequently left-sided (55.6%) and 19.4% of subjects required hospitalization. On the basis of these data we estimate that 71000 adult men and women sustain a distal forearm fracture in Britain each year. Compared with previous British surveys the pattern of incidence with age appears to have changed in women, the reason for this is unclear. Author Affiliation: (1) ARC Epidemiology Research Unit, Manchester University, Manchester, GB (2) MRC Environmental Epidemiology Unit, Southampton University, Southampton, GB (3) Center for Metabolic Bone Disease, Hull Royal Infirmary, Kingston upon Hull, GB (4) Department of Medicine and Therapeutics, Foresterhill, Aberdeen, GB (5) National Osteoporosis Society, Bath, GB (6) Department of Rheumatology, Royal Cornwall Hospital, Truro, GB (7) Department of Orthopaedic and Accident Surgery, Queens Medical Center, Nottingham, UK, GB Article note: Received: August 2000 / Accepted: January 2001

Published
2001

17. Prevalent Vertebral Deformity Predicts Incident Hip though not distal Forearm Fracture: Results from the European Prospective Osteoporosis Study

Author

Ismail, A.A., Cockerill, W., Cooper, C., Finn, J.D., Abendroth, K., Parisi, G., Banzer, D., Benevolenskaya, L.I., Bhalla, A.K., Bruges Armas, J., Cannata, J.B., Delmas, P.D., Dequeker, J., Dilsen, G., Eastell, R., Ershova, O., Falch, J.A., Felsch, B., Havelka, S., Hoszowski, K., Jajic, I., Kragl, U., Johnell, O., Lopez Vaz, A., Lorenc, R., Lyritis, G., Marchand, F., Masaryk, P., Matthis, C., Miazgowski, T., Pols, H.A.P., Poor, G., Rapado, A., Raspe, H.H., Reid, D.M., Reisinger, W., Janott, J., Scheidt-Nave, C., Stepan, J, Todd, C., Weber, K., Woolf, A. D., Ambrecht, G., Gowin, W., Felsenberg, D., Lunt, M., Kanis, J.A., Reeve, J., Silman, A.J., and O'Neill, T.W.

Subjects
Fractures -- Research, Fractures -- Risk factors, Osteoporosis -- Research, Osteoporosis -- Risk factors, Health
Abstract

Byline: A. A. Ismail (1), W. Cockerill (1), C. Cooper (2), J. D. Finn (1), K. Abendroth (3), G. Parisi (4), D. Banzer (5), L. I. Benevolenskaya (6), A. K. Bhalla (7), J. Bruges Armas (8), J. B. Cannata (9), P. D. Delmas (10), J. Dequeker (11), G. Dilsen (12), R. Eastell (13), O. Ershova (14), J. A. Falch (15), B. Felsch (3), S. Havelka (16), K. Hoszowski (17), I. Jajic (18), U. Kragl (19), O. Johnell (20), A. Lopez Vaz (21), R. Lorenc (17), G. Lyritis (22), F. Marchand (23), P. Masaryk (24), C. Matthis (25), T. Miazgowski (26), H. A. P. Pols (27), G. Poor (28), A. Rapado (29), H. H. Raspe (25), D. M. Reid (30), W. Reisinger (31), J. Janott (32), C. Scheidt-Nave (33), J Stepan (34), C. Todd (35), K. Weber (36), A. D. Woolf (37), G. Ambrecht (38), W. Gowin (38), D. Felsenberg (38), M. Lunt (1), J. A. Kanis (39), J. Reeve (35), A. J. Silman (1), T. W. O'Neill (1) Keywords: Key words: Incidence -- Limb fracture -- Osteoporosis -- Vertebral deformity -- Vertebral osteoporosis Abstract: The presence of a vertebral deformity increases the risk of subsequent spinal deformities. The aim of this analysis was to determine whether the presence of vertebral deformity predicts incident hip and other limb fractures. Six thousand three hundred and forty-four men and 6788 women aged 50 years and over were recruited from population registers in 31 European centers and followed prospectively for a median of 3 years. All subjects had radiographs performed at baseline and the presence of vertebral deformity was assessed using established morphometric methods. Incident limb fractures which occurred during the follow- up period were ascertained by annual postal questionnaire and confirmed by radiographs, review of medical records and personal interview. During a total of 40348 person-years of follow-up, 138 men and 391 women sustained a limb fracture. Amongst the women, after adjustment for age, prevalent vertebral deformity was a strong predictor of incident hip fracture, (rate ratio (RR) = 4.5 95% CI 2.1--9.4) and a weak predictor of 'other' limb fractures (RR = 1.6 95% CI 1.1--2.4), though not distal forearm fracture (RR = 1.0 95% CI 0.6--1.6). The predictive risk increased with increasing number of prevalent deformities, particularly for subsequent hip fracture: for two or more deformities, RR = 7.2 (95% CI 3.0--17.3). Amongst men, vertebral deformity was not associated with an increased risk of incident limb fracture though there was a nonsignificant trend toward an increased risk of hip fracture with increasing number of deformities. In summary, prevalent radiographic vertebral deformities in women are a strong predictor of hip fracture, and to a lesser extent humerus and 'other' limb fractures however, they do not predict distal forearm fractures. Author Affiliation: (1) ARC Epidemiology Unit, University of Manchester, Manchester, UK, GB (2) University of Southampton, Southampton General Hospital, Southampton, UK, GB (3) Clinic for Internal Medicine, Jena, Germany, DE (4) Institute of Clinical Medicine, University of Siena, Siena, Italy, IT (5) Behring Hospital, Berlin, Germany, DE (6) Institute of Rheumatology, Moscow, Russia, RU (7) Royal National Hospital for Rheumatic Diseases, Bath, UK, GB (8) Hospital de Angra do Heroismo, Azores, Portugal, PT (9) Asturia General Hospital, Oviedo, Spain, ES (10) Ho^pital Edouard Herriot, Lyon, France, FR (11) Rheumatology Unit, University Hospital, Leuven, Belgium, BE (12) Medical Faculty, University of Istanbul, Istanbul, Turkey, TR (13) Bone Metabolism Group, Northern General Hospital, Sheffield, UK, GB (14) Medical Institute, Yaroslavl, Russia, RU (15) Aker Hospital, Oslo, Norway, NO (16) Institute of Rheumatology, Prague, Czech Republic, CS (17) PKP Hospital, Warsaw, Poland, PL (18) Clinical Hospital, Zagreb, Croatia, YU (19) Medical Academy, Erfurt, Germany, DE (20) MalmoA' University Hospital, MalmoA', Sweden, SE (21) Hospital de San Joao, Oporto, Portugal, PT (22) Laboratory for the Research of Musculoskeletal System, University of Athens, Athens, Greece, GR (23) Centre de Medecine SpecialiseA'e, Montceau-les-Mines, France, FR (24) Institute of Rheumatic Diseases, Piestany, Slovakia, YU (25) Institute of Social Medicine, Lubeck, Germany, DE (26) Academy of Medicine, Szczecin, Poland, PL (27) Department of Epidemiology and Department of Internal Medicine, Erasmus University, Rotterdam, Netherlands, NL (28) National Institute of Rheumatology and Physiotherapy, Budapest, Hungary, HU (29) Faculty of Medicine, University of Madrid, Madrid, Spain, ES (30) Department of Medicine and Therapeutics, University of Aberdeen, UK, UK (31) Institute for Diagnostic Radiology, Humboldt University, Berlin, Germany, DE (32) Department of Clinical Medicine, Ruhr University, Bochum, Germany, DE (33) Department of Endocrinology, University of Heidelberg, Heidelberg, Germany, DE (34) Department of Internal Medicine, Charles University, Prague, Czech Republic, CZ (35) Institute of Public Health, Cambridge, UK, GB (36) Department of Medicine, University Hospital, Graz, Austria, AT (37) Royal Cornwall Hospital, Truro, UK, GB (38) Department of Radiology and Nuclear Medicine, Free University, Berlin, Germany, DE (39) Centre for Metabolic Bone Disease, Sheffield, UK, GB Article note: Received: 23 February 2000 / Accepted: 11 August 2000

Published
2001

18. Low BMD is less predictive than reported falls for future limb fractures in women across Europe: results from the European Prospective Osteoporosis Study

Author

Kaptoge, S., Benevolenskaya, L.I., Bhalla, A.K., Cannata, J.B., Boonen, S., Falch, J.A., Felsenberg, D., Finn, J.D., Nuti, R., Hoszowski, K., Lorenc, R., Miazgowski, T., Jajic, I., Lyritis, G., Masaryk, P., Naves-Diaz, M., Poor, G., Reid, D.M., Scheidt-Nave, C., Stepan, J.J., Todd, C.J., Weber, K., Woolf, A.D., Roy, D.K., Lunt, M., Pye, S.R., O'Neill, T.W., Silman, A.J., and Reeve, J.

Published
2005
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19. Investigating the determinants of international differences in the prevalence of chronic widespread pain: evidence from the European Male Ageing Study

Author

Macfarlane, G.J., Pye, S.R., Finn, J.D., Wu, F.C.W., Silman, A.J., Bartfai, G., Boonen, S., Casanueva, F., Forti, G., Giwercman, A., Han, T.S., Huhtaniemi, I.T., Kula, K., Lean, M.E.J., O'Neill, T.W., Pendleton, N., Punab, M., and Vanderschueren, D.

Subjects
Chronic pain -- Psychological aspects, Chronic pain -- Demographic aspects, Chronic pain -- Research, Chronic pain -- Health aspects, Epidemiology -- Research, Affective disorders -- Risk factors, Health
Published
2009

22. Management of Patients With High Baseline Hip Fracture Risk by FRAX Reduces Hip Fractures-A Post Hoc Analysis of the SCOOP Study

Author

McCloskey, E., Johansson, H., Harvey, N.C., Shepstone, L., Lenaghan, E., Fordham, R., Harvey, I., Howe, A., Cooper, C., Clarke, S., Gittoes, N., Heawood, A., Holland, R., Marshall, T., O'Neill, T.W., Peters, T.J., Redmond, N., Torgerson, D., Kanis, J.A., and SCOOP Study Team

Abstract

The Screening for Osteoporosis in Older Women for the Prevention of Fracture (SCOOP) study was a community-based screening intervention in women aged 70 to 85 years in the United Kingdom. In the screening arm, licensed osteoporosis treatments were recommended in women identified to be at high risk of hip fracture using the FRAX risk assessment tool (including bone mineral density measurement). In the control arm, standard care was provided. Screening led to a 28% reduction in hip fractures over 5 years. In this planned post hoc analysis, we wished to examine for interactions between screening effectiveness on fracture outcome (any, osteoporotic, and hip fractures) on the one hand and baseline FRAX 10-year probability of hip fracture on the other. All analyses were conducted on an intention-to-treat basis, based on the group to which women were randomized, irrespective of whether screening was completed. Of 12,483 eligible participants, 6233 women were randomized to screening, with treatment recommended in 898 (14.4%). No evidence of an effect or interaction was observed for the outcomes of any fracture or osteoporotic fracture. In the screening arm, 54 fewer hip fractures were observed than in the control arm (164 versus 218, 2.6% versus 3.5%), and commensurate with treatment being targeted to those at highest hip fracture risk, the effect on hip fracture increased with baseline FRAX hip fracture probability (p = 0.021 for interaction); for example, at the 10th percentile of baseline FRAX hip probability (2.6%), there was no evidence that hip fractures were reduced (hazard ratio [HR] = 0.93; 95% confidence interval [CI] 0.71 to 1.23), but at the 90th percentile (16.6%), there was a 33% reduction (HR = 0.67; 95% CI 0.53 to 0.84). Prior fracture and parental history of hip fracture positively influenced screening effectiveness on hip fracture risk. We conclude that women at high risk of hip fracture based on FRAX probability are responsive to appropriate osteoporosis management. © 2018 American Society for Bone and Mineral Research.

Published
2018

24. Is the predictive power of previous fractures for new spine and non-spine fractures associated with biochemical evidence of altered bone remodelling? The EPOS study

Author

Vergnaud, P, Lunt, M, Scheidt-Nave, C, Poor, G, Gennari, C, Hoszowski, K, Lopes Vaz, A, Reid, D.M, Benevolenskaya, L, Grazio, S, Weber, K, Miazgowski, T, Stepan, J.J, Masaryk, P, Galan, F, Bruges Armas, J, Lorenc, R, Havelka, S, Perez Cano, R, Seibel, M, Armbrecht, G, Kaptoge, S, O'Neill, T.W, Silman, A.J, Felsenberg, D, Reeve, J, and Delmas, P.D

Published
2002
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25. Occurrence and risk factors for falls in rheumatoid arthritis

Author

Armstrong, C., Swarbrick, C.M., Pye, S.R., and O'Neill, T.W.

Subjects
Rheumatoid arthritis -- Risk factors, Rheumatoid arthritis -- Care and treatment, Falls (Accidents) -- Physiological aspects, Falls (Accidents) -- Prevention, Health
Published
2005

26. Degenerative inter-vertebral disc disease osteochondrosis intervertebralis in Europe: Prevalence, geographic variation and radiological correlates in men and women aged 50 and over

Author

Armbrecht, G. Felsenberg, D. Ganswindt, M. Lunt, M. Kaptoge, S.K. Abendroth, K. Dias, A.A. Bhalla, A.K. Andia, J.C. Dequeker, J. Eastell, R. Hoszowski, K. Lyritis, G. Masaryk, P. van Meurs, J. Miazgowski, T. Nuti, R. Póor, G. Redlund-Johnell, I. Reid, D.M. Schatz, H. Todd, C.J. Woolf, A.D. Rivadeneira, F. Javaid, M.K. Cooper, C. Silman, A.J. O'Neill, T.W. Reeve, J. Banzer, D. Reisinger, W. Kragl, G. Weber, K. Scheidt-Nave, C. Delmas, P.D. Raspe, H. Johnell, O. Benevolenskaya, L.I. Aroso, A. Cannata, J. Masaryk, P. Havelka, S. Pols, H. Yershova, O. Jajic, I. the joint European Vertebral Osteoporosis Study European Prospective Osteoporosis Study Groups

Subjects
musculoskeletal diseases
Abstract

Objectives. To assess the prevalences across Europe of radiological indices of degenerative inter-vertebral disc disease (DDD); and to quantify their associations with, age, sex, physical anthropometry, areal BMD (aBMD) and change in aBMD with time. Methods. In the population-based European Prospective Osteoporosis Study, 27 age-stratified samples of men and women from across the continent aged 50+ years had standardized lateral radiographs of the lumbar and thoracic spine to evaluate the severity of DDD, using the Kellgren-Lawrence (KL) scale. Measurements of anterior, mid-body and posterior vertebral heights on all assessed vertebrae from T4 to L4 were used to generate indices of end-plate curvature. Results. Images from 10 132 participants (56% female, mean age 63.9 years) passed quality checks. Overall, 47% of men and women had DDD grade 3 or more in the lumbar spine and 36% in both thoracic and lumbar spine. Risk ratios for DDD grades 3 and 4, adjusted for age and anthropometric determinants, varied across a three-fold range between centres, yet prevalences were highly correlated in men and women. DDD was associated with flattened, non-ovoid inter-vertebral disc spaces. KL grade 4 and loss of inter-vertebral disc space were associated with higher spine aBMD. Conclusion. KL grades 3 and 4 are often used clinically to categorize radiological DDD. Highly variable European prevalences of radiologically defined DDD grades 3+ along with the large effects of age may have growing and geographically unequal health and economic impacts as the population ages. These data encourage further studies of potential genetic and environmental causes. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved.

Published
2017

27. Determinants of the size of incident vertebral deformities in European men and women in the sixth to ninth decades of age: the European Prospective Osteoporosis Study (EPOS)

Author

Reeve, J., Lunt, M., Felsenberg, D., Silman, A.J., Scheidt-Nave, C., Poor, G., Gennari, C., Weber, K., Lorenc, R., Masaryk, P., Cannata, J.B., Dequeker, J., Reid, D.M., Pols, H.A., Benevolenskaya, L.I., Stepan, J.J., Miazgowski, T., Bhalla, A., Bruges, Armas J., Eastell, R., Lopes-Vaz, A., Lyritis, G., Jajić, Ivo, Woolf, A.D., Banzer, D., Reisinger, W., Todd, C.J., Felsch, B., Havelka, S., Hoszowski, K., Janott, J., Johnell, O., Raspe, H.H., Yershova, O.B., Kanis, J.A., Armbrecht, G., Finn, J.D., Gowin, W., and O'Neill, T.W.

Subjects
Male, medicine.medical_specialty, Bone density, Endocrinology, Diabetes and Metabolism, Osteoporosis, osteoporosis, vertebral fractures, cohort study, radiological morphometry, fracture risk, macromolecular substances, Bone Density, medicine, Deformity, Humans, Orthopedics and Sports Medicine, Prospective Studies, Prospective cohort study, Osteoporosis, Postmenopausal, Aged, Aged, 80 and over, Orthodontics, business.industry, musculoskeletal, neural, and ocular physiology, Middle Aged, Prognosis, medicine.disease, Height loss, Spine, Surgery, Vertebra, Europe, medicine.anatomical_structure, nervous system, Fracture (geology), Spinal Fractures, Female, medicine.symptom, business, Cohort study
Abstract

More severe vertebral fractures have more personal impact. In the European Prospective Osteoporosis Study, more severe vertebral collapse was predictable from prior fracture characteristics. Subjects with bi-concave or crush fractures at baseline had a 2-fold increase in incident fracture size and thus increased risk of a disabling future fracture. Introduction: According to Euler's buckling theory, loss of horizontal trabeculae in vertebrae increases the risk of fracture and suggests that the extent of vertebral collapse will be increased in proportion. We tested the hypothesis that the characteristics of a baseline deformity would influence the size of a subsequent deformity. Methods: In 207 subjects participating in the European Prospective Osteoporosis Study who suffered an incident spine fracture in a previously normal vertebra, we estimated loss of volume (fracture size) from plane film images of all vertebral bodies that were classified as having a new fracture. The sum of the three vertebral heights (anterior, mid-body, and posterior) obtained at follow-up was subtracted from the sum of the same measures at baseline. Each of the summed height loss for vertebrae with a McCloskey-Kanis deformity on the second film was expressed as a percentage. Results and Conclusions: In univariate models, the numbers of baseline deformities and the clinical category of the most severe baseline deformity were each significantly associated with the size of the most severe incident fracture and with the cumulated sum of all vertebral height losses. In multivariate modeling, age and the clinical category of the baseline deformity (crush > bi-concave > uni-concave > wedge) were the strongest determinants of both more severe and cumulative height loss. Baseline biconcave and crush fractures were associated at follow-up with new fractures that were approximately twice as large as those seen with other types of deformity or who previously had undeformed spines. In conclusion, the characteristics of a baseline vertebral deformity determines statistically the magnitude of vertebral body volume lost when a subsequent fracture occurs. Because severity of fracture and number of fractures are determinants of impact, the results should improve prediction of the future personal impact of osteoporosis once a baseline prevalent deformity has been identified.

Published
2016

28. Systematic screening using FRAX® leads to increased use of, and adherence to, anti-osteoporosis medications: an analysis of the UK SCOOP trial.

Author

Parsons, C.M., Harvey, N., Shepstone, L., Kanis, J.A., Lenaghan, E., Clarke, S., Fordham, R., Gittoes, N., Harvey, I., Holland, R., Redmond, N.M., Howe, A., Marshall, T., Peters, T.J., Torgerson, D., O'Neill, T.W., McCloskey, E., Cooper, C., the SCOOP Trial Group, and Crabtree, N.

Subjects
CONFIDENCE intervals, DRUGS, BONE fractures, HIP joint injuries, OSTEOPOROSIS, PATIENT compliance, QUESTIONNAIRES, RISK assessment, WOMEN'S health, LOGISTIC regression analysis, PHOTON absorptiometry, OLD age
Abstract

Summary: In the large community-based SCOOP trial, systematic fracture risk screening using FRAX® led to greater use of AOM and greater adherence, in women at high fracture risk, compared with usual care. Introduction: In the SCreening of Older wOmen for Prevention of fracture (SCOOP) trial, we investigated the effect of the screening intervention on subsequent long-term self-reported adherence to anti-osteoporosis medications (AOM). Methods: SCOOP was a primary care–based UK multicentre trial of screening for fracture risk. A total of 12,483 women (70–85 years) were randomised to either usual NHS care, or assessment using the FRAX® tool ± dual-energy X-ray absorptiometry (DXA), with medication recommended for those found to be at high risk of hip fracture. Self-reported AOM use was obtained by postal questionnaires at 6, 12, 24, 36, 48 and 60 months. Analysis was limited to those who initiated AOM during follow-up. Logistic regression was used to explore baseline determinants of adherence (good ≥ 80%; poor < 80%). Results: The mean (SD) age of participants was 75.6 (4.2) years, with 6233 randomised to screening and 6250 to the control group. Of those participants identified at high fracture risk in the screening group, 38.2% of those on treatment at 6 months were still treated at 60 months, whereas the corresponding figure for the control group was 21.6%. Older age was associated with poorer adherence (OR per year increase in age 0.96 [95% CI 0.93, 0.99], p = 0.01), whereas history of parental hip fracture was associated with greater rate adherence (OR 1.67 [95% CI 1.23, 2.26], p < 0.01). Conclusions: Systematic fracture risk screening using FRAX® leads to greater use of AOM and greater adherence, in women at high fracture risk, compared with usual care. [ABSTRACT FROM AUTHOR]

Published
2020
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30. Vertebral Scheuermann’s disease in Europe: prevalence, geographic variation and radiological correlates in men and women aged 50 and over

Author

Armbrecht, G. Felsenberg, D. Ganswindt, M. Lunt, M. Kaptoge, S.K. Abendroth, K. Aroso, A. Banzer, D. Bhalla, A.K. Dequeker, J. Eastell, R. Hoszowski, K. Lyritis, G. Delmas, P.D. Masaryk, P. Miazgowski, T. Cannata, J. Nuti, R. Oei, L. Poor, G. Redlund-Johnell, I. Reid, D.M. Reisinger, W. Schatz, H. Todd, C.J. Woolf, A.D. Javaid, K. Rivadeneira, F. Silman, A.J. Cooper, C. O’Neill, T.W. Reeve, J.

Subjects
musculoskeletal diseases
Abstract

Summary: In 27 centres across Europe, the prevalence of deforming spinal Scheuermann’s disease in age-stratified population-based samples of over 10,000 men and women aged 50+ averaged 8 % in each sex, but was highly variable between centres. Low DXA BMD was un-associated with Scheuermann’s, helping the differential diagnosis from osteoporosis. Introduction: This study aims to assess the prevalence of Scheuermann’s disease of the spine across Europe in men and women over 50 years of age, to quantitate its association with bone mineral density (BMD) and to assess its role as a confounder for the radiographic diagnosis of osteoporotic fracture. Methods: In 27 centres participating in the population-based European Vertebral Osteoporosis Study (EVOS), standardised lateral radiographs of the lumbar and of the thoracic spine from T4 to L4 were assessed in all those of adequate quality. The presence of Scheuermann’s disease, a confounder for prevalent fracture in later life, was defined by the presence of at least one Schmorl’s node or irregular endplate together with kyphosis (sagittal Cobb angle >40° between T4 and T12) or a wedged-shaped vertebral body. Alternatively, the (rare) Edgren-Vaino sign was taken as diagnostic. The 6-point-per-vertebral-body (13 vertebrae) method was used to assess osteoporotic vertebral shape and fracture caseness. DXA BMD of the L2–L4 and femoral neck regions was measured in subsets. We also assessed the presence of Scheuermann’s by alternative published algorithms when these used the radiographic signs we assessed. Results: Vertebral radiographic images from 4486 men and 5655 women passed all quality checks. Prevalence of Scheuermann’s varied considerably between centres, and based on random effect modelling, the overall European prevalence using our method was 8 % with no significant difference between sexes. The highest prevalences were seen in Germany, Sweden, the UK and France and low prevalences were seen in Hungary, Poland and Slovakia. Centre-level prevalences in men and women were highly correlated. Scheuermann’s was not associated with BMD of the spine or hip. Conclusions: Since most of the variation in population impact of Scheuermann’s was unaccounted for by the radiological and anthropometric data, the search for new genetic and environmental determinants of this disease is encouraged. © 2015, International Osteoporosis Foundation and National Osteoporosis Foundation.

Published
2015

31. Vertebral Scheuermann's disease in Europe: prevalence, geographic variation and radiological correlates in men and women aged 50 and over

Author

Armbrecht, G., Felsenberg, D., Ganswindt, M., Lunt, M., Kaptoge, S.K., Abendroth, K., Aroso, A., Banzer, D., Bhalla, A.K., Dequeker, J., Eastell, R., Hoszowski, K., Lyritis, G., Delmas, P.D., Masaryk, P., Miazgowski, T., Cannata, J., Nuti, R., Oei, L., Poor, G., Redlund-Johnell, I., Reid, D.M., Reisinger, W., Schatz, H., Todd, C., Woolf, A.D., Javaid, K., Rivadeneira, F., Silman, A.J., Cooper, C., O'Neill, T.W., Reeve, J., Todd, C.J., Kragl, G., Weber, K., Scheidt-Nave, C., Raspe, H., Johnell, O., Benevolenskaya, L., Havelka, S., Pols, H., Yershova, O., and Jajić, Ivo

Subjects
Male, musculoskeletal diseases, medicine.medical_specialty, Pediatrics, Bone density, Endocrinology, Diabetes and Metabolism, Bone mineral density, Fracture, Osteoporosis, Scheuermann’s disease, Aged, Body Height, Bone Density, Europe, Female, Femur Neck, Humans, Lumbar Vertebrae, Middle Aged, Prevalence, Reproducibility of Results, Scheuermann Disease, Population, Kyphosis, bone mineral density, fracture, osteoporosis, Lumbar vertebrae, Endocrinology, medicine, education, Femoral neck, education.field_of_study, Cobb angle, business.industry, medicine.disease, Radiography, Diabetes and Metabolism, medicine.anatomical_structure, Physical therapy, business, Scheuermann's disease
Abstract

The Summary In 27 centres across Europe, the prevalence of deforming spinal Scheuermann's disease in age-stratified population-based samples of over 10,000 men and women aged 50+ averaged 8 % in each sex, but was highly variable between centres. Low DXA BMD was un-associated with Scheuermann's, helping the differential diagnosis from osteoporosis. Introduction This study aims to assess the prevalence of Scheuermann's disease of the spine across Europe in men and women over 50 years of age, to quantitate its association with bone mineral density (BMD) and to assess its role as a confounder for the radiographic diagnosis of osteoporotic fracture. Methods In 27 centres participating in the population-based European Vertebral Osteoporosis Study (EVOS), standardised lateral radiographs of the lumbar and of the thoracic spine from T4 to L4 were assessed in all those of adequate quality. The presence of Scheuermann's disease, a confounder for prevalent fracture in later life, was defined by the presence of at least one Schmorl's node or irregular endplate together with kyphosis (sagittal Cobb angle > 40A degrees between T4 and T12) or a wedged-shaped vertebral body. Alternatively, the (rare) Edgren-Vaino sign was taken as diagnostic. The 6-point-per-vertebral-body (13 vertebrae) method was used to assess osteoporotic vertebral shape and fracture caseness. DXA BMD of the L2-L4 and femoral neck regions was measured in subsets. We also assessed the presence of Scheuermann's by alternative published algorithms when these used the radiographic signs we assessed. Results Vertebral radiographic images from 4486 men and 5655 women passed all quality checks. Prevalence of Scheuermann's varied considerably between centres, and based on random effect modelling, the overall European prevalence using our method was 8 % with no significant difference between sexes. The highest prevalences were seen in Germany, Sweden, the UK and France and low prevalences were seen in Hungary, Poland and Slovakia. Centre-level prevalences in men and women were highly correlated. Scheuermann's was not associated with BMD of the spine or hip. Conclusions Since most of the variation in population impact of Scheuermann's was unaccounted for by the radiological and anthropometric data, the search for new genetic and environmental determinants of this disease is encouraged.

Published
2015
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34. Determinants of incident vertebral fracture in men and women: Results from the European Prospective Osteoporosis Study (EPOS)

Author

Roy, D.K. O'Neill, T.W. Finn, J.D. Lunt, M. Silman, A.J. Felsenberg, D. Armbrecht, G. Banzer, D. Benevolenskaya, L.I. Bhalla, A. Armas, J.B. Cannata, J.B. Cooper, C. Dequeker, J. Diaz, M.N. Eastell, R. Yershova, O.B. Felsch, B. Gowin, W. Havelka, S. Hoszowski, K. Ismail, A.A. Jajic, I. Janott, I. Johnell, O. Kanis, J.A. Kragl, G. Vaz, A.L. Lorenc, R. Lyritis, G. Masaryk, P. Matthis, C. Miazgowski, T. Gennari, C. Pols, H.A.P. Poor, G. Raspe, H.H. Reid, D.M. Reisinger, W. Scheidt-Nave, C. Stepan, J.J. Todd, C.J. Weber, K. Woolf, A.D. Reeve, J.

Abstract

The aim of this analysis was to determine the influence of lifestyle, anthropometric and reproductive factors on the subsequent risk of incident vertebral fracture in men and women aged 50-79 years. Subjects were recruited from population registers from 28 centers across Europe. At baseline, they completed an interviewer-administered questionnaire and had lateral thoraco-lumbar spine radiographs performed. Repeat spinal radiographs were performed a mean of 3.8 years later. Incident vertebral fractures were defined morphometrically and also qualitatively by an experienced radiologist. Poisson regression was used to determine the influence of the baseline risk factor variables on the occurrence of incident vertebral fracture. A total of 3173 men (mean age 63.1 years) and 3402 women (mean age 62.2 years) contributed data to the analysis. In total there were 193 incident morphometric and 224 qualitative fractures. In women, an age at menarche 16 years or older was associated with an increased risk of vertebral fracture (RR = 1.80; 95%CI 1.24, 2.63), whilst use of hormonal replacement was protective (RR=0.58; 95%CI 0.34, 0.99). None of the lifestyle factors studied including smoking, alcohol intake, physical activity or milk consumption showed any consistent associations with incident vertebral fracture. In men and women, increasing body weight and body mass index were associated with a reduced risk of vertebral fracture though, apart from body mass index in men, the confidence intervals embraced unity. For most variables the strengths of the associations observed were similar using the qualitative and morphometric approaches to fracture definition. In conclusion our data suggest that modification of other lifestyle risk factors is unlikely to have a major impact on the population occurrence of vertebral fractures. The important biological mechanisms underlying vertebral fracture risk need to be explored using new investigational strategies.

Published
2003

35. The relationship between bone density and incident vertebral fracture in men and women

Author

O'Neill T.W., Cooper C., Lunt, M., Silman, A.J., Felsenberg, D., Benevolenskaya, L.I., Bhalla, A.K., Cannata, J.B., Crabtree, N., Dequeker, J., Hoszowski, K., Jajic, Ivo, Kanis, J.A., Kragl, G., Lopes, Vaz A., Lorenc, R., Lyritis, G., Masaryk, P., Miazgowski, T., Parisi, G., Pols, H.A.P., Poor, G., Reid, D.M., Scheidt-Nave, C., Stepan, J., Todd, C., Weber, K., Woolf, A.D. and Reeve, and J. EPOS Study Group.

Subjects
The relationship between bone density and incident vertebral fracture in men and women
Abstract

The relationship between bone density and incident vertebral fracture in men and women

Published
2002

36. Differences in the characteristics of responders and non-responders in a prevalence survey of vertebral osteoporosis. European Vertebral Osteoporosis Study Group

Author

O’Neill, T.W., Marsden, D., Silman, A.J., and and the European Vertebral Osteoprosis Study Group:… Jajić, Ivo

Subjects
epidemiology, nonresponse bias, osteoporosis, vertebral fractures
Abstract

Men and women aged 50 years and over were recruited for participation in a population-based prevalence survey of vertebral osteoporosis from 36 centres in 19 European countries. All subjects were invited to attend by letter of invitation for a ''lifestyle'' interview and lateral spinal radiograph. The aim of this analysis was to investigate how far those who agreed to attend were representative of the target population and thus whether any important level of non-response bias existed. To address this a second invitation was sent to all non-responders and, in 20 centres, a sample of ultimate non-responders was contacted by mail, telephone or home visit and given a shortened version of the lifestyle questionnaire. Compared with the sample of non-responders, responders might be considered less at risk from osteoporosis in that as a group they took more exercise and were less likely to be current smokers. Other factors suggested the contrary in that they consumed less calcium and were more likely to have suffered a previous fracture. Amongst responders, these factors appeared also to be related to the timing of response. Thus compared with delayed responders, those who participated after a first letter of invitation took more exercise, were less likely to be smokers and more likely to have suffered a previous fracture. However, in contrast to the results suggested by the non-response survey early responders consumed more calcium than late responders. The magnitude of the differences between responders and non-responders was small (less than 10% for most of the categorical variables) and the differences were not consistently in the direction of an increased or decreased risk of osteoporosis. Additionally the size or direction of these differences was not consistently influenced by the response rate based on classifying centres into those with a high, medium or low response rate. This suggests that in this multicentre study response bias probably does not have a major influence on the prevalence estimates of vertebral fracture. In epidemiological studies of osteoporosis comparison of the lifestyle differences between early and late responders provides useful information concerning response characteristics.

Published
1995
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37. Variations in bone density in Europe and the risk of spinal deformity

Author

Lunt, M., Adams, J., Benevolunskaya, L., Cannata, J., Dequeker, J., Dodenhof, C., Falch, J., Felsenberg, D., Kanis, J., Masaryk, P, O’Neill, T.W., Pols, H., Poor, G., Reeve, J., Reid, D., Scheidt-Nave, C., Silman, A., Weber, K., and Jajić, Ivo

Subjects
Orthodontics, Histology, Bone density, Physiology, business.industry, Endocrinology, Diabetes and Metabolism, Spinal deformity, Medicine, General Medicine, xxx, business
Abstract

xxx

Published
1995
Full Text
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